Role Of Physiotherapy In Stroke

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Role Of Physiotherapy In Stroke

Stroke Recovery Physiotherapy

What is a stroke?

A stroke occurs when there is a loss of blood supply to a portion of the brain. Without oxygen, the brain cells start to die because of the blockage or burst blood vessel.

If the brain cells are irreversibly damaged, then they are unable to heal themselves. However, a brain is adaptable and capable of learning new tasks to compensate the areas that have been damaged. Physiotherapy helps the body to re-learn the normal movement patterns.

Types of stroke:

There are two types of stroke. They are

  1. Ischemic stroke
  2. Haemorrhagic stroke

Ischemic stroke:

Ischaemic stroke is the most common type of stroke. It occurs when there is a blockage in an artery. This blockage restricts the blood flow to an area of the brain that causes damage to the brain cells.

Hemorrhagic stroke (brain hemorrhages):

Hemorrhagic stroke occurs when the artery inside the brain ruptures and causes bleeding in the brain. This will cause a high pressure and damages the delicate brain tissue. Due to lack of oxygen, the blood flow to the neighboring blood cells can also be damaged.

Treatment for stroke:

There are three important stages of treating stroke. They are

  1. Prevention
  2. Therapy immediately after stroke
  3. Post-stroke rehabilitation

Post-Stroke Rehabilitation Guidelines

There are therapies to prevent the first or recurrent stroke based on the individual’s underlying risk factors such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies try to dissolve the blood clot that causes an ischemic stroke or stop the bleeding of a hemorrhagic stroke. The most popular drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics.

Benefits of Neuro physiotherapy:

Physiotherapy plays an important role in the process of rehabilitation. The physiotherapy treatment after a stroke helps the body to return to its normal. The benefits of physiotherapy treatment are as follows

  1. Improves the body balance which reduces the risk of falls.
  2. Increases the ability to roll/move.
  3. Reduces muscle spasms, pain, and stiffness.
  4. Increases the strength and functioning of affected arm/leg.
  5. Increases the energy level of the body.
  6. Retains the normal movement/patterns of the body.
  7. Increases the independence and quality of life.

Types of physiotherapy treatments:

Many types of treatments are followed after stroke for immediate recovery and rehabilitation. The physiotherapist will assess the patient and plans an appropriate program for recovery.

Manual therapy:

Manual therapy helps in the treatment of muscular ailments through ‘hands-on’ techniques and physical intervention. This form of treatment is included for soft tissue mobilization, myofascial release, craniosacral techniques, joint manipulation, mobilization of neural tissue, visceral mobilization strain and counter strain, movement with mobilization and Integrative manual therapy.

Neurodevelopment treatment – Bobath technique:

This technique helps to inhibit synergies and spasticity by inhibitory postures and movements to facilitate normal automatic responses that are voluntary movements. This treatment process helps to increase the independence of the patient by gradually decreasing the input of practitioner.

Alexander technique:

Alexander technique is a simple and practical method of changing the movement habits in our everyday activities. It improves the ease and freedom of movement balance for support and coordination. This technique teaches the use of an appropriate amount of effort for a particular activity by giving more energy for all activities.

Rolfing:

Rolfing helps in the manipulation of soft tissues or myofascial system for the proper alignment and whole organization of the whole body in gravity. It helps to loosen up the spastic muscles, smoothes out gait patterns and maintains the spine alignment.

Benefits of TENS Therapy for Stroke Rehab

Transcutaneous Electrical Nerve Stimulation

Vojta therapy:

This method is developed by Dr. Vaclav Vojta, a pediatric neurologist to enhance the motor development of a child. It has the added benefits of improvement in cognition fine motor breathing and digestion.

Muscle Re-education Approach:

The aim of this approach is to train the individual to develop coordinated movement patterns by learning the control of individual muscles on a cognitive level.

Knott and Voss PNF Approach:

Knott and Voss PNF Approach relies on quick stretch and manual resistance of activating the muscle limbs that are often spiral or diagonal.

Rood’s Sensorimotor Approach:

Rood’s Sensorimotor approach involves superficial cutaneous stimulation using icing, brushing or stroking muscle stimulation with vibration to evoke voluntary activation of muscles.

Transcutaneous Electrical Nerve Stimulation (TENS):

In this method, a small extractable device is used to deliver electric impulses to the nerve endings which relieves from pain.

Bioelectric treatment:

In this treatment, a precise dose of bioelectric currents (electroceuticals) is administered through electrodes that are placed on the skin to cause a biological change and interrupt pain signals. This treatment is used for chronic and acute pain conditions which include complex, regional pain syndrome, back pain, muscle pain and headaches.

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